Ewing's Sarcoma of the Foot with Multiple Synchronous Lung Metastases

Introduction: The foot isexceptionally concerned by Ewing’s sarcoma (ES) and only a few sporadic cases of tarsal bones involvement have been reported in the literature.

We are reporting an original observation of tarsal ES with significant locoregional spread to other bones and soft tissues of the foot and multiple synchronous lung metastases.

Case report: The 13-year-old boy, with no pathological medical history, was admitted for left foot pain evolving for two months, and with progressive aggravation leading to functional left lower limb impotence.The somatic examination noted a painful left foot on palpation and the slightest mobilization, with a hard and sensitive mass at the level of the sole of the foot.Biology showed a marked inflammatory syndrome. Radiological investigations and local biopsy concluded to the diagnosis of foot ES involving tarsal and metatarsal bones with multiple and bilateral synchronous pulmonary metastases. The child was referred to pediatric oncology department for chemotherapy.

Conclusion: ES remains a rare primitive malignantbonetumor. The location at the foot is rare and tarsal involvement is exceptional. Pulmonary metastasis present at the moment of the diagnosis of ES is a major prognostic factor.

Keywords: Ewing’s sarcoma,tarsal bones,bone sarcoma, foot, lung metastases.